If you're EMPLOYED: You must have paid at least 9 monthly premiums or contributions within 12 months immediately prior to your delivery. Your month of delivery is included in the 12-month count.

Example: You will give birth in December; you must have paid 9 monthly premiums within 11 months prior to December plus December.

If VOLUNTARY or INDIVIDUAL PAYOR: The requirement is the same with that of Employed (since November 2013). You must have paid 9 monthly premiums within 12 months immediately prior to your delivery. Your month of delivery is included in the 12-month count.

Example: You will give birth in July; you should have paid 9 monthly premiums within 11 months prior to July plus July.

If OFW: Your date of delivery should be within your Validity Dates written in your Philhealth premium payment receipt.

Example: You will give birth in August 8, 2017 -- this date should be within the Validity Dates in your receipt. For example, you will be covered if your validity dates are September 3, 2016 to September 3, 2017, or December 25, 2016 to December 25, 2017.

If your Validity Dates are August 1, 2016 to August 1, 2017, you will not be able to use Philhealth because August 8, 2017 is outside your validity dates.

If SPONSORED or INDIGENT member: Your date of delivery should be within the Validity Dates in the Philhealth ID card given to you.

Example: You will give birth in July 4, 2017; this date should be within the Validity Dates in your card. For example, September 3, 2016 to September 3, 2017, or December 25, 2016 to December 25, 2017.

If your Validity Dates are June 4, 2016 to June 4, 2017, you will not be able to use your Philhealth card because July 4, 2017 is outside your Validity Dates.

If LIFETIME or SENIOR CITIZEN member: Oh-uh... I think no Lifetime Member or Senior Citizen will ask about their maternity benefit eligibility hehe :)
But for other medical treatments, yes, you are qualified anytime. You just need to present your Lifetime Member ID and your MDR plus photocopies. Kapag ang hospital ay linked sa Philhealth member database, hindi na kailangan ang MDR.

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Comments

Hi charm, let's say you're able to pay for Oct 2013 to Apr 2014 -- these count to only 7 months, not enough for the 9-month requirement. Your 2010 and 2011 payments are no longer considered because they're long past. BUT I've read an announcement from Philhealth in the news the other day that it will consider 3 premium payments from the informal sector -- I don't know yet the details, and if "informal sector"includes all individual payors and when these will be effective, so we hope that this change will be implemented for individual payors soon, so that you will qualify. Check the news from time to time, or check philhealth.gov.ph or healthphilippines.net from time to time.P.S. I've seen the new member form, and informal sector means tricycle drivers, vendors, etc. so if you're a professional, you might not be considered informal sector... but ask Philhealth, to be sure

maribel deleon : Ms. nora, paid apr to dec 2014 -- this is also the advice of someone at Philhealth. But the midwife at the facility where I'm having my checkups said that I should have paid 9 months backward, meaning further back to Jan. I'm confused and I doubt if I can really use my Philhealth in Oct. Thanks

Hi maribel, the midwife might not know yet the new Philhealth policy for individual payors. Have you told her gently that the rules have been changed? Ask her if you can give her a cert of eligibility from Philhealth, then request for this cert from Philhealth.Is she the only midwife there? If she'll be the one to help you deliver, and she insists on the old 9-month requirement, you might want to reconsider, or find another clinic. But ask the new clinic if they'll deduct your Philhealth coverage, because there's also a Philhealth-eligibility rule for clinics that you should have at least 4 prenatal checkups with them so you can use Philhealth. Ask others too

maribel deleon: My due date is Oct 3. But if I give birth earlier, in Sept., can I avail of my Philhealth? I had my checkup a while ago, and the midwife said that if I give birth in Oct, yes I can avail, but not if I give birth in Sept. Thanks.

Hi maribel, you can avail this month. You've paid Apr to Dec. If you give birth this month, you have paid 5 months before this month (you've paid Apr May Jun July Aug) -- more than enough -- more than the 3-month requirement.I'm so sad that the midwife is not giving you correct info. Pray that she has a change of heart.We can understand that they need cash also for their families...that it takes months before they get their Philhealth payments. But they should also understand the situation of patients, and do the right thing.

Cherry Mae Aquino 11/7/14What if I give birth in Dec instead of january? Can I avail?

Cherry Mae Aquino 12/4/14 Hi ms nora i already paid oct to dec but according to my ob they required at least 9 months of contribution. What should I do?REPLY:Hi Cherry Mae, the 9-within 12-month requirement has been reduced to 3-within-6-month requirement. If you give birth in Jan 2015, you can avail. If you give birth in Dec, you can avail (you paid for June, Oct and Nov). You can go to Philhealth and ask for certification of eligibility. Bring your premium ORs.

Hi maam, ask ko lang po ,Up to how many giving birth was covered of Philhealth. before I know up to 4... My OB told me starting last Dec.its up to 6 giving birth was covered by Philhealth. is it true??? Thank you, Vilma

Hi jenerose, the same with what you know, what I know is only up to 4 normal deliveries. I've tried looking if there's a new circular related to it, and I can't find any. I'll add to this, if I find something relevant

Hi ms.nora! Ask ko lang po,employed po ako last year and payed from April 2014-September 2014. Then nag-resign ako and changed to voluntary member noong October. I payed 600 for the last quarter(Oct-Dec). I'm 8mos.pregnant. I'm planning to pay the 1st quarter(Jan-March) this coming February. Due date ko last week of March. Can I avail the maternity benefits?Thanks!

jr junior 2/24/16hi,good day, may i ask if I can avail of philhealth maternity benefits if cs operation? I'm a member and started my contributions last july 2015. my due date is on october. will wait for your reply. thanksANSWER:Yes, CS is covered by Philhealth. Coverage is 19,000 pesos (7,600 for PF and 11,400 for hospital costs). Pay Apr to Sep 2016, so you can avail, or pay Jan to Dec 2016, so you're always covered. You can pay quarterly. Payment deadline for every quarter is the last day of the quarter.

enna 5/27/16Hi ms.nora. Will I be covered if my due date is august 2016 if I pay May June and July? I've been a member since 2014. Last payment was 2014 as employed.ANSWER:Hi enna, yes, if Philhealth allows you to pay for May to July. I think what they accept is April to June or April to Sep. You will be covered if you pay any of these. Update your data so you get a new MDR. Bring your ID.

Hi edjulyn: Yes, pay for Oct Nov Dec asap. Pay at Philhealth so you can get your new MDR and maybe ID card if available. Before paying, fill up registration form. Check FOR UPDATING, and check Informal Sector--No Income (Member status)

Hi Ynah: Yes, pay for Jan to March, and you can use Philhealth in June. Pay at Philhealth so you can get your new MDR as voluntary. Maganda rin na next quarter bayaran mo para may coverage just in case you need it.

Hi Jane: Sorry, I think no. 3 monthly payments within 6 months prior to giving birth is required. Month of giving birth is counted in the count of 6. You should have paid at least 3 months within Sep Oct Nov Dec Jan Feb. But to be sure, ask the hospital or clinic.

hi miss nora, i would like to ask po i was individual payor last APRL 2017 - SEPT 2017 and stop paying OCTOBER 2017 until April 2018, and now I'm already imployed and i start paying contribution may 2018 and my due date is SEPT. 2018 can i use po ba?

Hi po! I will be giving birth to my 1st baby this coming month of November and new member palang po ako ng Philhealth, last August lang po. Will I be eligible for the maternity benefits/ can I use Philhealth sa hospital? Or should I pay first the 9-12 months contribution in advance?

Hello, ang alam ko is once lang na ibinibigay yong change to use the Women about to give birth program (payment of 2400). Pero it's great na Oct ka pa naman, and you still have time to accumulate 9 monthly premium payments to be eligible. So PAY ASAP for Jan to March (deadline for this is last business day of March), then April to Sep (puedeng every month or every quarter) or pay mo na agad Jan to Sep para hindi mo na makalimutan (9 months na yan). Then after Sep, continue paying para lagi kang eligible lalo na at meron ka uli new baby